Graduated: 1983
NPI: 1073530804
Practice Locations (5)
5555 GLENRIDGE CONNECTOR, SUITE 700
ATLANTA, GA 303421681
940 MAIN ST
HACKENSACK, NJ 076015135
2818 31ST ST
ASTORIA, NY 111021745
1345 AVE OF HE AMERICAS
NEW YORK, NY 10105
740 STAFFORD AVE
STATEN ISLAND, NY 103092440
Source: CMS National Downloadable File, September 2026.